| Isla Blanca Llc | |
|
210 Calle Jose Oliver Apt 1209 San Juan PR 00918-2985 | |
| (201) 450-5043 | |
| Not Available |
| Full Name | Isla Blanca Llc |
|---|---|
| Speciality | General Practice |
| Location | 210 Calle Jose Oliver Apt 1209, San Juan, Puerto Rico |
| Authorized Official Name and Position | Victor H Cordero (PRESIDENT) |
| Authorized Official Contact | 2014505043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Isla Blanca Llc 210 Calle Jose Oliver Apt 1209 San Juan PR 00918-2985 Ph: (201) 450-5043 | Isla Blanca Llc 210 Calle Jose Oliver Apt 1209 San Juan PR 00918-2985 Ph: (201) 450-5043 |
| NPI Number | 1518736230 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 12/21/2023 |
| Medicare PECOS PAC ID | 8325486962 |
|---|---|
| Medicare Enrollment ID | O20240402002729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518736230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Victor H Cordero |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578916102 PECOS PAC ID: 9537413737 Enrollment ID: I20181106002083 |
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